HIV infections drop in highest risk group

New HIV infections among men who have sex with men, the risk group with the highest infection rate, fell 10 percent between 2014 and 2015, according to the state.

That’s the first drop in a decade and it’s being hailed as a major victory in the fight against HIV and AIDS by advocates and public health officials. Infection rates already have been falling among other risk groups.

"I guess I shouldn’t be surprised, but we are because we’ve never seen a drop before," said Wil Murtaugh, executive director of ACR Health.

The governor launched a plan in 2014 to end the AIDS epidemic.

"New York state is a national leader in ending the HIV/AIDS epidemic," said Erin Silk, a state Department of Health spokeswoman. "The goal of Gov. (Andrew) Cuomo’s Ending the Epidemic initiative is to reduce new HIV infections to an estimated 750 annually by the end of 2020 and achieve the first ever decrease in HIV prevalence in New York state. This initiative has expanded access to preventive treatment and had already helped to reduce new infections among New Yorkers statewide."

The strategy, implemented through nonprofit agencies working with the state, includes three prongs: more HIV testing, treatment as quickly as possible for those diagnosed with HIV (which keeps them healthier and keeps them from spreading HIV), and a prophylactic regimen known as PrEP for those at high risk of infection.

The new drop in cases among gay and bisexual men seems to be a sign that it’s working.

"It’s the impact that all the agencies are doing across the state, including ACR Health, in ending the epidemic," Murtaugh said. "So we’re thinking it’s going to be a trend (into the future) across the state because of the governor’s plan."

In 2014, 1,975 men who have sex with men were diagnosed with HIV in New York, according to the state Department of Health’s AIDS Institute. That number fell to 1,775 in 2015, the latest year for which data is available. In total, there were 3,155 new cases of HIV diagnosed among all groups in 2015.

Back in the late 1980s and early 1990s, the spread of HIV was largely fueled by injection drug use and shared needles, Silk pointed out. But cooperation among governments at all levels, researchers, advocates, community groups and consumers has led to a more than 50 percent drop in new cases among injection drug users (if one also includes men who both use injection drugs and have sex with other men) between 2010 and 2015, she said.

Syringe exchanges, such as the one offered by ACR Health in Utica, have played a key role in this reduction.

Helping to hook people up with insurance — a task made easier with the insurance marketplace, Medicaid expansion and low-cost essential health plan (for those who don’t quite qualify for Medicaid) created under the Affordable Care Act — has helped, too, said Steve Wood, director of insurance programs for ACR Health. It’s helped people get tested and kept HIV patients healthy, he said.

But under a state plan, anyone at high risk for HIV can get PrEP — which costs about $1,200 a month — for free, he said. The state covers costs not covered by insurance.

"Within that community (of men who have sex with men) we find PrEP is very well accepted," Wood said. "But there’s been a huge kind of grassroots movement with the (men who have sex with men) community to get people educated about PrEP and to get as many people as possible on it."

But not all barriers have been eliminated. An Oswego County man died of AIDS at age 32, just six months after his initial HIV diagnosis, because he was afraid to get tested, Murtaugh said.

"He’s just too young and there’s no reason for that today," he said. "And we try to erase stigma, but it’s still there and it’s a burden on people."

Murtaugh also stressed the absolute confidentiality of testing and the fact that no one else has to know the results.

PrEP is great, Murtaugh said, but he also warned people not to rely on it too much.

"It’s the best thing since a condom that has been around in AIDS prevention since I’ve been in the business," he said. "Of course, we also recommend that people take PrEP and also use condoms because you can get a lot of things other than HIV."

And he expressed hope that preventing new infections is just the next step, not the last.

"My hopefulness has gone up since a cure for hepatitis C has been found. Who knew that would ever happen?" Murtaugh asked. "My hope is that someday there’ll be a cure for HIV."